Change these things in spine, 6 surgeons say


From policy to patient access, here are the aspects of the spine surgery industry that six surgeons would want to change.

Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. Becker's invites all spine surgeon and specialist responses.

Next week's question: How are you addressing physician and healthcare employee safety where you work?

Please send responses to Carly Behm at by 5 p.m. CDT Wednesday, Aug. 23.

Editor's note: Responses were lightly edited for clarity and length.

Question: What's one thing you would change about the spine surgery industry?

Brian Fiani, DO. Mendelson Kornblum Orthopedic & Spine Specialists (West Bloomfield, Mich.): One thing that would be good to change about the spine industry is improving access to innovative and minimally invasive procedures. This can help reduce the need for more invasive surgeries, resulting in quicker recovery times and less postoperative pain for patients. Additionally, advancements in technology should be embraced to enhance diagnostic and treatment options, allowing for more personalized and effective care.

Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: The made-up guidelines that are cherry picked or just fabricated that act as blocks to get our patients care.  Congress is trying to address this, but the insurance companies' crafty attorneys are awfully well-paid and have a very strong lobby.  

Richard Kube II, MD. Prairie Spine & Pain Institute (Peoria, Ill.): The industry is overly regulated. I cannot say that I have seen any of the touted patient safety improved care concepts play out as a result of the regulation. There are simply more boxes to fill, which take time away from the care the patients need. It is increasingly harder to work with industry to innovate and develop. Most companies find themselves limited to what they can reimburse hourly. As a solo surgeon with a facility and staff, etc, I am in the red any time I consult for an implant company. Hospitals increasingly tell physicians what to do. The regulation hits from all sides.

Bjorn Lobo, MD. DISC Sports and Spine Center (Newport Beach, Calif.): I would like to see better cost transparency in spine surgery in terms of biological and hardware implants. Surgeons are an integral part of managing healthcare costs, and lack of this knowledge may be harmful in the long term. For instance, this information would help us work with our facilities to advocate for certain implants that could be slightly more expensive, but more cost effective in the long term than other devices that are cheaper but have worse long-term durability.

Issada Thongtrangan, MD. MicroSpine (Scottsdale, Ariz.): Less nonsense pre-authorization. In addition, if the payers can be more up to date with the new "proven" technologies such as endoscopic spine surgery, disc replacement and facet joint replacement. It is burdensome to do peer-to-peer or appeal on a daily basis.

Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): The one change that this practitioner would impart in the spine surgery industry would be a better understanding and refocusing as it applies to the costs of spinal implants, hospitalization and adjusted fees that vary from one region to another. Standardization of implant costs have lagged pharmaceutical costs of late but will have a new awareness as health systems continue to struggle.

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